1960 



1 1 1. MAN ANATOMY. 



anus and perineum, the hip-joint and sacro-iliac articulation of the affected side and 

 the other side of the thigh, due to the association of the vesical, prostate, and pelvic 

 plexuses with the lumbar and sacral nerves and their plexuses. 



Vesiculitis may be a very serious condition, as it may result in abscess with per- 

 foration into the bladder within the limits of the peritoneal covering, or directly into 

 tin- peritoneal cavity by way of the recto-vesical cul-de-sac. Cases of both these acci- 

 dents have been reported. Pyaemia has also been known to follow a septic phlebitis 

 i.f the adjacent venous plexuses; pelvic cellulitis with diffuse suppuration has resulted; 

 and various troublesome abscesses burrowing between the bladder and rectum, and 

 leaving fistulous tracts very slow to heal, have had their origin in suppurative vesicu- 

 litis. The chronic form may be associated with persistent vesical irritability, with some 

 pain on emission of semen, with sexual excitability accompanied by premature ejacu- 

 lation, and with persistent urethral discharge often mistaken for an ordinary gleet. 



In chronic cases "massage" through the rectum has been advised and practised 

 with some benefit in comparatively rare cases. The contents of the vesicles can 

 sometimes be pressed through the ejaculatory ducts into the prostatic urethra and so 

 evacuated. A similar expression of the normal secretion of the vesicles by fecal 

 masses at stool is a fertile source of sexual hypochondriasis in young male neuras- 

 thenics, who, in consequence, imagine that they are afflicted with "spermatorrhoea." 



FIG. 



THE SPERMATIC CORD. 



In consequence of its migration from the abdominal cavity into the scrotal sac, 

 the testicle is followed by its duct, vessels, and nerves through the abdominal wall 

 into the scrotum. These structures, held together by connective tissue and invested 

 by certain coverings acquired in their descent, form a cylindrical mass, known as the 

 spermatic cord (funiculus spermaticus), that extends from the internal abdominal ring 

 obliquely along the inguinal canal, emerging at the external ring, and thence descends 

 vertically, beneath the integument, into the scrotum to end at the posterior border of 

 the testicle. Most constant within the inguinal canal, where its diameter is about 

 15 mm. (f in.), the thickness and length of the spermatic cord vary with the con- 

 traction of the cremasteric muscular fibres that 

 1 6 7- control the position of the testicle. 



Posterior veins The constituents of the spermatic cord 



are numerous and fall under four groups. 



1 . The vas deferens with its accompanying 

 deferential artery and plexuses of veins, lym- 

 phatics, and nerves. The vas, surrounded by 

 its artery and a venous plexus, occupies the 

 posterior part of the spermatic cord, and is 

 readily distinguished as a hard, round cord, 

 from 2-3 mm. in diameter, by virtue of its 

 unusually firm walls. 



2. The spermatic artery, zr/V/.v, lymphatics, 

 and nerves belonging to the testicle proper. 

 In contrast to the artery, the veins are particu- 

 larly large and numerous and form the conspicuous pampiniform plexus which con- 

 tributes in no small measure to the bulk of the cord. 



I'hr coverings ://// tlich blood-vessels and nerves. The coverings proper of 

 the spermatic (.ml, contributed by the layers of the abdominal wall, correspond to 

 tlio-M- of tin- testicle, with the exception of the serous coat, which is wanting after 

 el,, Mire of the proresMis va^inalis. From within outward they are : (a) the infundib- 

 /////<>>/ fascia imik-a \ainaliN omimimis , a distinct layer continued from the trans- 

 venalu fa-,<-ia ; i /' i the o<nist<n'< fascia, consisting of the muscular fibres prolonged 

 from the internal oblique and transversalis, blended together by connective tissue. 

 Th. miiM-ular tibn-s descend as loops along the spermatic cord, especially on the 

 ; i. .r surfac-e as far as the testicle, over the coverings of which they spread out in 

 festoons and net-works ; and (c) the intercolumnar fascia, a delicate sheet derived 

 from the aponeurosis of the external oblique at the margin of the external abdominal 



Vas deferens 



Veins of panipini- 

 form plexus 



'"-Spermatic artery 



1'imii :i va^inalis 



comonntt 



Cremasteric fascia 



Section across left spermatic cord hardened in 

 formalin, showing position <>f vas di-fcn-ns. 



